JONATHAN MICHAEL RIDDELL

LAWTON, OK
NPI1306332853
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: AR  PTA4317)
Enumeration Date2018-07-09
Last Update Date2018-07-09
Business Address
JONATHAN MICHAEL RIDDELL PTA
3401 W GORE BLVD
LAWTON, OK 73505-6332
Phone number: 580-355-8620
Mailing Address
JONATHAN MICHAEL RIDDELL PTA
4 W RAZORBACK RD
ROGERS, AR 72758-9570
Phone number: 479-899-4049
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